Multifidus fat infiltration negatively influences the postoperative outcomes in lumbar disc herniation following transforaminal approach percutaneous endoscopic lumbar discectomy

Abstract Purpose This study aims to investigate the influence of multifidus muscle fat infiltration on clinical outcomes in lumbar disc herniation (LDH) undergoing percutaneous endoscopic lumbar discectomy (PELD). Methods A retrospective analysis was conducted on 224 patients who underwent lateral P...

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Main Authors: Kai Sun, Renjie Qin, Wenzhuo Wang, Genlong Jiao, Guodong Sun, Guoliang Chen, Jun Li
Format: Article
Language:English
Published: BMC 2025-01-01
Series:European Journal of Medical Research
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Online Access:https://doi.org/10.1186/s40001-025-02283-2
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author Kai Sun
Renjie Qin
Wenzhuo Wang
Genlong Jiao
Guodong Sun
Guoliang Chen
Jun Li
author_facet Kai Sun
Renjie Qin
Wenzhuo Wang
Genlong Jiao
Guodong Sun
Guoliang Chen
Jun Li
author_sort Kai Sun
collection DOAJ
description Abstract Purpose This study aims to investigate the influence of multifidus muscle fat infiltration on clinical outcomes in lumbar disc herniation (LDH) undergoing percutaneous endoscopic lumbar discectomy (PELD). Methods A retrospective analysis was conducted on 224 patients who underwent lateral PELD, with complete one-year follow-up data. Patients were divided into two groups based on preoperative MRI evaluation of L4 multifidus muscle fat infiltration: a mild group (< 25%) and a severe group (≥ 25%). Baseline characteristics and postoperative outcomes were recorded and compared. Results At the final follow-up, significant improvements in VAS scores for back and leg pain, ODI scores, and EQ-5D scores were observed in both groups. There were no statistically significant differences in preoperative VAS scores for back and leg pain, ODI scores, and EQ-5D scores between the two groups. However, significant differences were found in VAS scores for back pain, ODI scores, and EQ-5D scores at 3, 6, and 12 months postoperatively (P < 0.05), while no significant difference was noted in VAS scores for leg pain during follow-up. The total recurrence rate was 6.7% (15 out of 224 cases), with 12 cases in the severe group and 3 cases in the mild group, showing a statistically significant difference (P < 0.05). Conclusion The effectiveness of postoperative PELD in patients with LDH is impacted by severe multifidus muscle fat infiltration. Multifidus muscle fat infiltration represents a risk factor for recurrent LDH after PELD.
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spelling doaj-art-767156d807e4457a85c465e7cea028122025-01-26T12:21:41ZengBMCEuropean Journal of Medical Research2047-783X2025-01-013011910.1186/s40001-025-02283-2Multifidus fat infiltration negatively influences the postoperative outcomes in lumbar disc herniation following transforaminal approach percutaneous endoscopic lumbar discectomyKai Sun0Renjie Qin1Wenzhuo Wang2Genlong Jiao3Guodong Sun4Guoliang Chen5Jun Li6Department of Orthopedic Surgery, The Fifth Affiliated Hospital of Jinan University (Hayuan Shenhe Peolple’s Hospital)Department of Orthopedic Surgery, The First Affiliated Hospital of Jinan UniversityDepartment of Orthopedic Surgery, The First Affiliated Hospital of Jinan UniversityDepartment of Orthopedic Surgery, The First Affiliated Hospital of Jinan UniversityDepartment of Orthopedic Surgery, Jiujiang University Clinical Medical College (Jiujiang University Affiliated Hospital)Department of Orthopedic Surgery, The First Affiliated Hospital of Jinan UniversityDepartment of Orthopedic Surgery, Jiujiang University Clinical Medical College (Jiujiang University Affiliated Hospital)Abstract Purpose This study aims to investigate the influence of multifidus muscle fat infiltration on clinical outcomes in lumbar disc herniation (LDH) undergoing percutaneous endoscopic lumbar discectomy (PELD). Methods A retrospective analysis was conducted on 224 patients who underwent lateral PELD, with complete one-year follow-up data. Patients were divided into two groups based on preoperative MRI evaluation of L4 multifidus muscle fat infiltration: a mild group (< 25%) and a severe group (≥ 25%). Baseline characteristics and postoperative outcomes were recorded and compared. Results At the final follow-up, significant improvements in VAS scores for back and leg pain, ODI scores, and EQ-5D scores were observed in both groups. There were no statistically significant differences in preoperative VAS scores for back and leg pain, ODI scores, and EQ-5D scores between the two groups. However, significant differences were found in VAS scores for back pain, ODI scores, and EQ-5D scores at 3, 6, and 12 months postoperatively (P < 0.05), while no significant difference was noted in VAS scores for leg pain during follow-up. The total recurrence rate was 6.7% (15 out of 224 cases), with 12 cases in the severe group and 3 cases in the mild group, showing a statistically significant difference (P < 0.05). Conclusion The effectiveness of postoperative PELD in patients with LDH is impacted by severe multifidus muscle fat infiltration. Multifidus muscle fat infiltration represents a risk factor for recurrent LDH after PELD.https://doi.org/10.1186/s40001-025-02283-2Percutaneous endoscopic lumbar discectomyMultifidus muscle fat infiltrationLumbar disc herniation
spellingShingle Kai Sun
Renjie Qin
Wenzhuo Wang
Genlong Jiao
Guodong Sun
Guoliang Chen
Jun Li
Multifidus fat infiltration negatively influences the postoperative outcomes in lumbar disc herniation following transforaminal approach percutaneous endoscopic lumbar discectomy
European Journal of Medical Research
Percutaneous endoscopic lumbar discectomy
Multifidus muscle fat infiltration
Lumbar disc herniation
title Multifidus fat infiltration negatively influences the postoperative outcomes in lumbar disc herniation following transforaminal approach percutaneous endoscopic lumbar discectomy
title_full Multifidus fat infiltration negatively influences the postoperative outcomes in lumbar disc herniation following transforaminal approach percutaneous endoscopic lumbar discectomy
title_fullStr Multifidus fat infiltration negatively influences the postoperative outcomes in lumbar disc herniation following transforaminal approach percutaneous endoscopic lumbar discectomy
title_full_unstemmed Multifidus fat infiltration negatively influences the postoperative outcomes in lumbar disc herniation following transforaminal approach percutaneous endoscopic lumbar discectomy
title_short Multifidus fat infiltration negatively influences the postoperative outcomes in lumbar disc herniation following transforaminal approach percutaneous endoscopic lumbar discectomy
title_sort multifidus fat infiltration negatively influences the postoperative outcomes in lumbar disc herniation following transforaminal approach percutaneous endoscopic lumbar discectomy
topic Percutaneous endoscopic lumbar discectomy
Multifidus muscle fat infiltration
Lumbar disc herniation
url https://doi.org/10.1186/s40001-025-02283-2
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